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A4635 — Underarm pad, crutch, replacement, each

HCPCS Level II A-code · short descriptor: “Underarm crutch pad”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Inexpensive or routinely purchased
Prior authorization
Not on Medicare required-PA list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

A4635 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $6.19 to $15.36 depending on state and rural status.

Former-CBA payment limits: ceiling $7.28 · floor $6.19

StateNon-ruralRural
AK$14.36
AL$6.19
AR$6.19
AZ$6.19
CA$7.28
CO$7.28
CT$6.19
DC$6.19
DE$6.19
FL$6.19
GA$6.19
HI$15.36
IA$7.28
ID$6.19
IL$6.19
IN$7.28
KS$6.19
KY$7.28
LA$6.19
MA$7.28
MD$7.28
ME$7.28
MI$6.19
MN$6.19
MO$7.28
MS$7.28
MT$7.28
NC$6.19
ND$7.28
NE$6.45
NH$7.28
NJ$7.28
NM$6.19
NV$6.19
NY$7.28
OH$6.26
OK$7.28
OR$7.28
PA$6.19
PR$7.89
RI$7.28
SC$6.19
SD$7.28
TN$6.19
TX$6.19
UT$7.28
VA$7.28
VI$7.28
VT$6.19
WA$7.28
WI$7.28
WV$7.28
WY$7.28

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $0.84 to $1.48 depending on state and rural status.

Former-CBA payment limits: ceiling $0.99 · floor $0.84

StateNon-ruralRural
AK$1.35
AL$0.91
AR$0.94
AZ$0.99
CA$0.99
CO$0.99
CT$0.84
DC$0.99
DE$0.84
FL$0.84
GA$0.84
HI$1.48
IA$0.99
ID$0.99
IL$0.94
IN$0.84
KS$0.92
KY$0.99
LA$0.95
MA$0.99
MD$0.99
ME$0.99
MI$0.84
MN$0.84
MO$0.99
MS$0.99
MT$0.99
NC$0.84
ND$0.99
NE$0.99
NH$0.99
NJ$0.99
NM$0.95
NV$0.99
NY$0.92
OH$0.84
OK$0.99
OR$0.99
PA$0.84
PR$1.02
RI$0.99
SC$0.84
SD$0.99
TN$0.90
TX$0.94
UT$0.96
VA$0.99
VI$0.92
VT$0.84
WA$0.96
WI$0.99
WV$0.90
WY$0.99

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $4.13 to $11.51 depending on state and rural status.

Former-CBA payment limits: ceiling $4.86 · floor $4.13

StateNon-ruralRural
AK$10.75
AL$4.13
AR$4.13
AZ$4.13
CA$4.86
CO$4.86
CT$4.13
DC$4.13
DE$4.13
FL$4.13
GA$4.13
HI$11.51
IA$4.86
ID$4.15
IL$4.13
IN$4.86
KS$4.51
KY$4.86
LA$4.13
MA$4.86
MD$4.86
ME$4.86
MI$4.13
MN$4.28
MO$4.86
MS$4.86
MT$4.86
NC$4.13
ND$4.86
NE$4.86
NH$4.86
NJ$4.86
NM$4.13
NV$4.13
NY$4.85
OH$4.72
OK$4.86
OR$4.86
PA$4.13
PR$5.97
RI$4.86
SC$4.13
SD$4.86
TN$4.13
TX$4.13
UT$4.86
VA$4.86
VI$4.85
VT$4.13
WA$4.86
WI$4.86
WV$4.86
WY$4.86
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related A-codes

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